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Gamaletsou MN, Rammaert B, Brause B, Bueno MA, Dadwal SS, Henry MW, Katragkou A, Kontoyiannis DP, McCarthy MW, Miller AO, Moriyama B, Pana ZD, Petraitiene R, Petraitis V, Roilides E, Sarkis JP, Simitsopoulou M, Sipsas NV, Taj-Aldeen SJ, Zeller V, Lortholary O, Walsh TJ. Osteoarticular Mycoses. Clin Microbiol Rev 2022; 35:e0008619. [PMID: 36448782 PMCID: PMC9769674 DOI: 10.1128/cmr.00086-19] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Osteoarticular mycoses are chronic debilitating infections that require extended courses of antifungal therapy and may warrant expert surgical intervention. As there has been no comprehensive review of these diseases, the International Consortium for Osteoarticular Mycoses prepared a definitive treatise for this important class of infections. Among the etiologies of osteoarticular mycoses are Candida spp., Aspergillus spp., Mucorales, dematiaceous fungi, non-Aspergillus hyaline molds, and endemic mycoses, including those caused by Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides species. This review analyzes the history, epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, inflammatory biomarkers, diagnostic imaging modalities, treatments, and outcomes of osteomyelitis and septic arthritis caused by these organisms. Candida osteomyelitis and Candida arthritis are associated with greater events of hematogenous dissemination than those of most other osteoarticular mycoses. Traumatic inoculation is more commonly associated with osteoarticular mycoses caused by Aspergillus and non-Aspergillus molds. Synovial fluid cultures are highly sensitive in the detection of Candida and Aspergillus arthritis. Relapsed infection, particularly in Candida arthritis, may develop in relation to an inadequate duration of therapy. Overall mortality reflects survival from disseminated infection and underlying host factors.
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Affiliation(s)
- Maria N. Gamaletsou
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Blandine Rammaert
- Université de Poitiers, Faculté de médecine, CHU de Poitiers, INSERM U1070, Poitiers, France
| | - Barry Brause
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Marimelle A. Bueno
- Far Eastern University-Dr. Nicanor Reyes Medical Foundation, Manilla, Philippines
| | | | - Michael W. Henry
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Aspasia Katragkou
- Nationwide Children’s Hospital, Columbus, Ohio, USA
- The Ohio State University School of Medicine, Columbus, Ohio, USA
| | | | - Matthew W. McCarthy
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Andy O. Miller
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Zoi Dorothea Pana
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Ruta Petraitiene
- Weill Cornell Medicine of Cornell University, New York, New York, USA
| | | | - Emmanuel Roilides
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | | | - Maria Simitsopoulou
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Nikolaos V. Sipsas
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Valérie Zeller
- Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Olivier Lortholary
- Université de Paris, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR 2000, Paris, France
| | - Thomas J. Walsh
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
- Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA
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Rocha-Silva F, Maria de Figueiredo S, Rutren La Santrer EF, Machado AS, Fernandes B, Assunção CB, Góes AM, Caligiorne RB. Paracoccidioidomycosis: Detection of Paracoccidioides brasiliensis´ genome in biological samples by quantitative chain reaction polymerase (qPCR). Microb Pathog 2018; 121:359-362. [PMID: 29803846 DOI: 10.1016/j.micpath.2018.05.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 05/17/2018] [Accepted: 05/23/2018] [Indexed: 12/01/2022]
Abstract
Paracoccidioidomycosis (PCM) is a chronic mycosis caused by the saprobic and dimorphic species Paracoccidioides brasiliensis and P. lutzii. This disease is prevalent in Latin American countries. PCM appears as a relevant concern and challenge for the mycologists, since until now there is no a methodology suitable for an efficient and safe diagnosis and species identification. Thus, the present study aimed to validate a methodology for PCM´s diagnosis, using quantitative Polymerase Chain Reaction (qPCR) through target amplification of the gene encoding the recombinant protein Pb27, a common protein to the both species Paracoccidioides brasiliensis and P. lutzii. The experiments were performed in vitro to determine the specificity, efficiency and detection limit of qPCR assay, using specific primers and probe, which sequences were subject to a patent deposited in Brazilian CTIT, under the registration number: BR1020160078830. According to the results the technique showed sensitivity of 94% and specificity of 100%, demonstrating that it will be possible to develop a new fast and safe diagnostic PCM and can be standardized in order to present a low cost, accessible to the patient served by the public health system in Brazil and Latin America.
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Affiliation(s)
- Fabiana Rocha-Silva
- Núcleo de Pós-Graduação e Pesquisa da Santa Casa de Belo Horizonte, MG, Brazil Rua Domingos Vieira, 590 - 30150240, Belo Horizonte, Brazil
| | - Sônia Maria de Figueiredo
- Núcleo de Pós-Graduação e Pesquisa da Santa Casa de Belo Horizonte, MG, Brazil Rua Domingos Vieira, 590 - 30150240, Belo Horizonte, Brazil; Departamento de Alimentos, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil
| | | | - Amanda Sanchez Machado
- Núcleo de Pós-Graduação e Pesquisa da Santa Casa de Belo Horizonte, MG, Brazil Rua Domingos Vieira, 590 - 30150240, Belo Horizonte, Brazil
| | - Blenda Fernandes
- Núcleo de Pós-Graduação e Pesquisa da Santa Casa de Belo Horizonte, MG, Brazil Rua Domingos Vieira, 590 - 30150240, Belo Horizonte, Brazil
| | - Claudia Barbosa Assunção
- Núcleo de Pós-Graduação e Pesquisa da Santa Casa de Belo Horizonte, MG, Brazil Rua Domingos Vieira, 590 - 30150240, Belo Horizonte, Brazil
| | - Alfredo Miranda Góes
- Departamento de Patologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Brazil
| | - Rachel Basques Caligiorne
- Núcleo de Pós-Graduação e Pesquisa da Santa Casa de Belo Horizonte, MG, Brazil Rua Domingos Vieira, 590 - 30150240, Belo Horizonte, Brazil.
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Savarese LG, Monsignore LM, de Andrade Hernandes M, Martinez R, Nogueira-Barbosa MH. Magnetic resonance imaging findings of paracoccidioidomycosis in the musculoskeletal system. Trop Med Int Health 2015; 20:1346-54. [PMID: 26138054 DOI: 10.1111/tmi.12552] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe magnetic resonance imaging (MRI) findings in musculoskeletal paracoccidioidomycosis (PCM). METHODS Retrospective case series study after IRB approval. Two musculoskeletal radiologists reviewed in consensus the MRI findings of 11 patients with microbiologically and/or pathologically proven osteoarticular PCM. The MRI evaluation included discrimination of abnormalities in joints, bones and soft tissues. RESULTS Mean age of patients was 29 years (10-55 years), eight men and three women. Musculoskeletal involvement was the only or the primary presentation of the disease in seven patients (63%). Osteomyelitis was the most common presentation, with seven cases (63%). Primary arthritis was found in one patient (9%). Isolated extra-articular soft tissue PCM was found in three patients: myositis (2) and subcutaneous infection (1). All cases showed regions with signal intensity higher than or similar to the signal of muscle on T1-weighted images. Penumbra sign was present in five cases (45%). T2-weighted images showed reactive soft tissue oedema in eight cases (72%). Post-gadolinium images showed peripheral (8/9) or heterogeneous (1/9) enhancement. Synovial enhancement was present in all cases of joint involvement (6/6). Lipomatosis arborescens was documented in one case of chronic knee involvement. CONCLUSION To our knowledge, this is the first case series describing MRI findings of musculoskeletal PCM. Musculoskeletal involvement was the primary presentation of the disease in most cases, and therefore, neoplasms were initially in the differential diagnosis. Osteomyelitis was the most common presentation, often with secondary involvement of joint and or soft tissue.
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Affiliation(s)
- Leonor G Savarese
- Division of Radiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Lucas M Monsignore
- Division of Radiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Roberto Martinez
- Division of Infectious Diseases, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Adizie T, Adebajo AO. Travel- and immigration-related problems in rheumatology. Best Pract Res Clin Rheumatol 2015; 28:973-85. [PMID: 26096097 DOI: 10.1016/j.berh.2015.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Health problems are self-reported by up to 64% of travellers to the developing world. Traditionally, rheumatic symptoms are accorded little significance, but many travellers do return home with musculoskeletal complaints. The assessment of these patients is often hindered by the Western clinician's lack of familiarity with the types of infections that the patient may have encountered while travelling. Standard serological tests for autoimmune diseases can be unreliable in the setting of concomitant tropical infection, and these infections themselves can have musculoskeletal manifestations. Even in the absence of tropical infection, laboratory investigation of musculoskeletal symptoms in individuals of different ethnicities is challenging due to genetic and physiological variation. This review focusses on addressing the impact global migration has had on rheumatological clinical practice.
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Affiliation(s)
- T Adizie
- Rheumatology Department, Solihull Hospital, Solihull B91 2JL, UK
| | - A O Adebajo
- Academic Rheumatology Group, Faculty of Medicine, University of Sheffield, Sheffield S10 2RX, UK.
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Lima Júnior FVA, Savarese LG, Monsignore LM, Martinez R, Nogueira-Barbosa MH. Computed tomography findings of paracoccidiodomycosis in musculoskeletal system. Radiol Bras 2015; 48:1-6. [PMID: 25798000 PMCID: PMC4366020 DOI: 10.1590/0100-3984.2014.0049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 08/01/2014] [Indexed: 11/21/2022] Open
Abstract
Objective To evaluate musculoskeletal involvement in paracoccidioidomycosis at computed
tomography. Materials and Methods Development of a retrospective study based on a review of radiologic and
pathologic reports in the institution database. Patients with histopathologically
confirmed musculoskeletal paracoccidioidomycosis and submitted to computed
tomography were included in the present study. The imaging findings were
consensually described by two radiologists. In order to avoid bias in the
analysis, one patient with uncountable bone lesions was excluded from the
study. Results A total of seven patients were included in the present study. A total of 18 bone
lesions were counted. The study group consisted of 7 patients. A total number of
18 bone lesions were counted. Osteoarticular lesions were the first manifestation
of the disease in four patients (57.14%). Bone lesions were multiple in 42.85% of
patients. Appendicular and axial skeleton were affected in 85.71% and 42.85% of
cases, respectively. Bone involvement was characterized by well-demarcated
osteolytic lesions. Marginal osteosclerosis was identified in 72.22% of the
lesions, while lamellar periosteal reaction and soft tissue component were present
in 5.55% of them. One patient showed multiple small lesions with bone
sequestra. Conclusion Paracoccidioidomycosis can be included in the differential diagnosis of either
single or multiple osteolytic lesions in young patients even in the absence of a
previous diagnosis of pulmonary or visceral paracoccidioidomycosis
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Affiliation(s)
- Francisco Valtenor Araújo Lima Júnior
- MDs, Residents of Radiology and Imaging Diagnosis, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRPUSP), Ribeirão Preto, SP, Brazil
| | - Leonor Garbin Savarese
- MDs, Residents of Radiology and Imaging Diagnosis, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRPUSP), Ribeirão Preto, SP, Brazil
| | - Lucas Moretti Monsignore
- Physician Assistant at Centro de Ciências das Imagens e Física Médica (CCIFM) da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRPUSP), Ribeirão Preto, SP, Brazil
| | - Roberto Martinez
- PhD, Professor, Department of Medical Practice, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Marcello Henrique Nogueira-Barbosa
- PhD, Professor, Centro de Ciências das Imagens e Física Médica (CCIFM) da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRPUSP), Ribeirão Preto, SP, Brazil
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